Accepted answer
50 units. Volume first: 10 mg ÷ 20 mg/mL = 0.5 mL. On a U-100 insulin syringe one unit is 0.01 mL, so 0.5 ÷ 0.01 = 50 units. It lands on a whole graduation, which is what you want from a reconstitution volume.
The arithmetic only stops being confusing once you work it through once and see that it is straightforward.
Worked example, because the general form is easier to trust once you have seen it once. Take a 10 mg vial and add 2 mL of diluent: the concentration is 10 ÷ 2 = 5 mg/mL. A 0.5 mg dose is 0.5 ÷ 5 = 0.1 mL. On a U-100 syringe, where 1 unit = 0.01 mL, that is 0.1 ÷ 0.01 = 10 units. Change the diluent to 1 mL and the same dose becomes 5 units — same dose, half the resolution.
Reading a lyophilised cake
| Appearance | Interpretation | Action |
|---|
| Intact opaque puck, proud of base | Cycle ran correctly | Proceed |
| Slumped to one side | Shipped before fully dry, or vibration | Usually usable; note it |
| Glassy translucent film | Collapse above glass transition | Test before use |
| Melt-back ring at stopper | Thermal excursion in transit | Test before use |
| No visible cake at all | Very low fill, or nothing there | Weigh it; query the supplier |
On the detail: number of stopper piercings matters less than the gauge doing the piercing. A 30G or 31G needle through a butyl stopper leaves a track that reseals; a 21G or 18G drawing needle punches a core and can drop it into the solution.
The Arrhenius relationship for drawing kinetics means that cold solution takes noticeably longer to draw than room-temperature solution.
If in doubt, use more diluent and accept the shorter usable window.